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Thyroid Function in Early Pregnancy, Child IQ, and Autistic Traits: A Meta-Analysis of Individual Participant Data
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Thyroid Function in Early Pregnancy, Child IQ, and Autistic Traits: A Meta-Analysis of Individual Participant Data
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Journal Article
Thyroid Function in Early Pregnancy, Child IQ, and Autistic Traits: A Meta-Analysis of Individual Participant Data
2018
Overview
Abstract
Context
Low maternal free T4 (FT4) has been associated with poor child neurodevelopment in some single-center studies. Evidence remains scarce for the potential adverse effects of high FT4 and whether associations differ in countries with different iodine status.
Objective
To assess the association of maternal thyroid function in early pregnancy with child neurodevelopment in countries with a different iodine status.
Design, Setting, and Participants
Meta-analysis of individual participant data from 9036 mother–child pairs from three prospective population-based birth cohorts: INMA [Infancia y Medio Ambiente (Environment and Childhood project) (Spain)], Generation R (Netherlands), and ALSPAC (Avon Longitudinal Study of Parents and Children, United Kingdom). The exclusion criteria were multiple pregnancies, fertility treatments, thyroid-interfering medication usage, and known thyroid disease.
Main Outcomes
Child nonverbal IQ at 5 to 8 years of age, verbal IQ at 1.5 to 8 years of age, and autistic traits within the clinical range at 5 to 8 years of age.
Results
FT4 <2.5th percentile was associated with a 3.9-point (95% CI, −5.7 to −2.2) lower nonverbal IQ and a 2.1-point (95% CI, −4.0 to −0.1) lower verbal IQ. A suggestive association of hypothyroxinemia with a greater risk of autistic traits was observed. FT4 >97.5th percentile was associated with a 1.9-fold (95% CI, 1.0 to 3.4) greater risk of autistic traits. No independent associations were found with TSH.
Conclusions
Low maternal FT4 was consistently associated with a lower IQ across the cohorts. Further studies are needed to replicate the findings of autistic traits and investigate the potential modifying role of maternal iodine status. FT4 seems a reliable marker of fetal thyroid state in early pregnancy, regardless of the type of immunoassay.
This study confirms that low FT4, but not TSH, during early pregnancy is associated with a lower IQ. We report a suggestive association of hypothyroxinemia and high maternal FT4 with autistic traits.
Publisher
Endocrine Society,Copyright Oxford University Press,Oxford University Press
Subject
/ Age
/ Autism
/ Autistic Disorder - epidemiology
/ Autistic Disorder - etiology
/ Autistic Disorder - physiopathology
/ Child
/ Child Development - physiology
/ Children
/ Female
/ Fetuses
/ Humans
/ Infant
/ Iodine
/ Male
/ Mothers - statistics & numerical data
/ Pregnancy Complications - blood
/ Pregnancy Complications - epidemiology
/ Pregnancy Complications - physiopathology
/ Pregnancy Trimester, First - blood
/ Prenatal Exposure Delayed Effects - blood
/ Prenatal Exposure Delayed Effects - physiopathology
/ Thyroid
/ Thyroid Diseases - complications
/ Thyroid Diseases - epidemiology
